| NPI | 1912992736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01029191) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01029191) |
| 2085N0904X (Licence: IN 01029191) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2007-10-18 |